Active NPI
Paul Pavilack, MD
- Anesthesiology Physician
- Hollywood, FL
National Provider Identifier
1487090205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- ME 11795
- Practice address
- 771 S Rainbow Dr
Hollywood, FL 33021-7517 - Phone
- (954) 987-6502
- Fax
- (305) 682-8997
- NPI assigned
- May 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | ME 11795 | FL | Primary |
Addresses
Primary practice location
771 S Rainbow Dr
Hollywood, FL 33021-7517
Mailing address
771 S Rainbow Dr
Hollywood, FL 33021-7517
Phone (954) 987-6502
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME 11795 | FL | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369008000000",
"number": "1487090205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 S RAINBOW DR",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330217517",
"telephone_number": "954-987-6502",
"fax_number": "305-682-8997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "771 S RAINBOW DR",
"city": "HOLLYWOOD",
"state": "FL",
"postal_code": "330217517",
"telephone_number": "954-987-6502",
"fax_number": "305-682-8997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAVILACK",
"first_name": "PAUL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-05-20",
"last_updated": "2013-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "FL",
"license": "ME 11795",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hollywood, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.